Cognition and saccadic eye movement performance are impaired in chronic rhinosinusitis.

Abstract

Patients with chronic rhinosinusitis (CRS) can experience cognitive dysfunction. The literature on this topic mostly reflects patient-reported measurements. Our goal was to assess cognitive function in patients with CRS using objective measures, including saccadic eye movements-a behavioral response reflecting cognitive and sensory information integration that is often compromised in conditions with impaired cognition. Participants (N=24 with CRS, N=23 non-CRS healthy controls) enrolled from rhinology clinic underwent sinonasal evaluation, quality of life assessment (Sino-nasal Outcome Test 22 [SNOT-22]), and cognitive assessment with the Neuro-QOL Cognitive Function-Short Form, the Montreal Cognitive Assessment (MoCA), and recording of eye movements using video-oculography. Participants with CRS were more likely to report cognitive dysfunction (Neuro-QOL; 45.8%vs. 8.7%; p=0.005) and demonstrate mild or greater cognitive impairment (MoCA; 41.7%vs. 8.7%; p=0.005) than controls. Additionally, participants with CRS performed worse on the MoCA overall and within the executive functioning and memory domains (all p<0.05) and on the anti-saccade (p=0.014) and delay saccade (p=0.044) eye movement tasks. Poorer performance on the MoCA (r=-0.422; p=0.003) and the anti-saccade (r=-0.347; p=0.017) and delay saccade (r=-0.419; p=0.004) eye movement tasks correlated with worse CRS severity according to SNOT-22 scores. This study is the first to utilize objective eye movement assessments in addition to researcher-administered cognitive testing in patients with CRS. These patients demonstrated a high prevalence of cognitive dysfunction, most notably within executive functioning and memory domains, with the degree of dysfunction correlating with the severity of CRS.